Title

Study to Compare TP-434 and Ertapenem in Community-acquired Complicated Intra-abdominal Infections
A Phase 2, Randomized, Double-Blind, Double-Dummy, Multicenter, Prospective Study to Assess the Efficacy, Safety, and PK of 2 Dose Regimens of TP-434 Compared With Ertapenem in Adult Community-Acquired Complicated Intra-abdominal Infections
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    143
This is a Phase 2, randomized, double-blind, double-dummy, multicenter, prospective study to assess the efficacy, safety, and pharmacokinetics of two dose regimens of TP-434 compared with ertapenem in the treatment of adult community-acquired complicated intra-abdominal infections (cIAIs).
Study Started
Jan 31
2011
Primary Completion
May 31
2012
Study Completion
May 31
2012
Results Posted
Sep 04
2015
Estimate
Last Update
Jan 06
2022

Drug TP-434

  • Other names: Eravacycline

Drug Ertapenem

  • Other names: Invanz

Drug Placebo

Administered IV to maintain the blind.

TP-434, 1.5 mg/kg q24h Experimental

TP-434 was administered intravenously (IV) at a dose of 1.5 milligrams per kilogram of body weight (mg/kg) every 24 hours (q24h) for a minimum of 4 days and a maximum of 14 days (7 days for participants in India). TP-434 treatment was to be stopped when symptoms of complicated intra-abdominal infection (cIAI) resolved, there was treatment failure, or the maximum allowed number of infusion days was reached.

TP-434, 1.0 mg/kg q12h Experimental

TP-434 was administered IV at a dose of 1.0 mg/kg every 12 hours (q12h) for a minimum of 4 days and a maximum of 14 days (7 days for participants in India). TP-434 treatment was to be stopped when symptoms of cIAI resolved, there was treatment failure, or the maximum allowed number of infusion days was reached.

Ertapenem, 1 g q24h Active Comparator

Ertapenem was administered IV at a dose of 1 gram (g) q24h for a minimum of 4 days and a maximum of 14 days (7 days for participants in India). Ertapenem treatment was to be stopped when symptoms of cIAI resolved, there was treatment failure, or the maximum allowed number of infusion days was reached.

Criteria

Inclusion Criteria:

Abdominal pain/discomfort with onset prior to hospitalization
Evidence of a systemic inflammatory response
Physical findings consistent with intra-abdominal infection (IAI)
Clinical diagnosis of community-acquired IAI requiring urgent surgical or percutaneous intervention and not expected to require antibacterial therapy for longer than 14 days
Body mass index (BMI) of ≤ 30 kilograms per square meter (kg/m^2)
Able to provide informed consent. If the participant is unable to provide informed consent, the participant's legally acceptable representative may provide written consent in accordance with institutional guidelines
If female, not pregnant or nursing or, if of child-bearing potential either: will commit to use at least two medically accepted, effective methods of birth control (for example, condom, oral contraceptive, indwelling intrauterine device, hormonal implant/patch, injections, approved cervical ring) during study drug dosing and for 90 days following last study drug dose or practicing sexual abstinence

Exclusion Criteria:

Symptoms related to diagnosis of complicated appendicitis (if current diagnosis) for < 24 hours prior to current hospitalization
Previously hospitalized or admitted to a healthcare facility within the last 6 months
Managed by Staged Abdominal Repair or other open abdomen technique
Known at study entry to have an IAI caused by a pathogen(s) resistant to both study drug antibiotics
Acute Physiology and Chronic Health Evaluation (APACHE) II score > 25
Unlikely to survive the 6-8 week study period
Any rapidly-progressing disease or immediately life-threatening illness, including acute hepatic failure, respiratory failure and septic shock
Requirement for vasopressors at therapeutic dosages
Renal failure
Presence or possible signs of hepatic disease
Hematocrit < 25% or hemoglobin < 8 grams per deciliter (g/dL)
Neutropenia with absolute neutrophil count < 1000 cells per cubic millimeter (mm^3)
Platelet count < 50,000/mm3
Abnormal coagulation tests or participant on anticoagulants
Immunocompromised condition, including known human immunodeficiency virus (HIV) positivity or acquired immune deficiency syndrome (AIDS), organ (bone marrow) transplant recipients, and hematological malignancy. Immunosuppressive therapy, including use of high-dose corticosteroids (for example, > 40 milligrams [mg] prednisone or equivalent per day for greater than 2 weeks)
History of hypersensitivity reactions to tetracyclines or carbapenems
Participation in any investigational drug or device study within 30 days prior to study entry
Known or suspected central nervous system (CNS) disorder that may predispose to seizures or lower seizure threshold
Previously received TP-434 in a clinical trial
More than 24 hours duration of systemic antibiotic coverage for current condition
Received ertapenem or any other carbapenem, or tigecycline for the current infection
Need for concomitant systemic antimicrobial agents other than study drug or received systemic (IV or oral) antibiotics in the last 3 months
Refusal of mechanical ventilation, dialysis or hemofiltration, cardioversion or any other resuscitative measures and drug/fluid therapy at time of consent
Known or suspected inflammatory bowel disease or associated visceral abscess

Summary

TP-434, 1.5 mg/kg q24h

TP-434, 1.0 mg/kg q12h

Ertapenem 1 g q24h

All Events

Event Type Organ System Event Term TP-434, 1.5 mg/kg q24h TP-434, 1.0 mg/kg q12h Ertapenem 1 g q24h

Clinical Response to TP-434 and Ertapenem in the Microbiologically Evaluable (ME) Population at the Test-of-Cure Visit

Clinical response was classified as cure (complete resolution or significant improvement of signs and symptoms of the index infection), failure (death related to complicated intra-abdominal infection [cIAI], persisting or recurrent infection within the abdomen, postsurgical wound infection, or administration of effective concomitant antibacterial therapy), or indeterminate (Test-of-Cure [TOC] assessment was not available, death unrelated to cIAI, or some other reason).

TP-434, 1.5 mg/kg q24h

Cure

39.0
participants

Failure

3.0
participants

Indeterminate

TP-434, 1.0 mg/kg q12h

Cure

41.0
participants

Failure

Indeterminate

Ertapenem 1 g q24h

Cure

24.0
participants

Failure

2.0
participants

Indeterminate

Clinical Response to TP-434 and Ertapenem in the Modified Intent-to-treat (MITT) Population at the End-of-Treatment (EOT) Visit

TP-434, 1.5 mg/kg q24h

Cure

49.0
participants

Failure

2.0
participants

Indeterminate

3.0
participants

TP-434, 1.0 mg/kg q12h

Cure

52.0
participants

Failure

1.0
participants

Indeterminate

3.0
participants

Ertapenem 1 g q24h

Cure

28.0
participants

Failure

1.0
participants

Indeterminate

Clinical Response to TP-434 and Ertapenem in the Modified Intent-to-treat (MITT) Population at TOC Visit

TP-434, 1.5 mg/kg q24h

Cure

46.0
participants

Failure

3.0
participants

Indeterminate

5.0
participants

TP-434, 1.0 mg/kg q12h

Cure

47.0
participants

Failure

1.0
participants

Indeterminate

8.0
participants

Ertapenem 1 g q24h

Cure

26.0
participants

Failure

2.0
participants

Indeterminate

1.0
participants

Clinical Response to TP-434 and Ertapenem in the Modified Intent-to-treat (MITT) Population at the Follow-up Visit

TP-434, 1.5 mg/kg q24h

Cure

41.0
participants

Failure

4.0
participants

Indeterminate

9.0
participants

TP-434, 1.0 mg/kg q12h

Cure

45.0
participants

Failure

1.0
participants

Indeterminate

10.0
participants

Ertapenem 1 g q24h

Cure

24.0
participants

Failure

2.0
participants

Indeterminate

3.0
participants

Clinical Response to TP-434 and Ertapenem in the Clinically Modified Intent-to-treat (c-MITT) Population at the EOT Visit

TP-434, 1.5 mg/kg q24h

Cure

49.0
participants

Failure

2.0
participants

Indeterminate

3.0
participants

TP-434, 1.0 mg/kg q12h

Cure

52.0
participants

Failure

1.0
participants

Indeterminate

3.0
participants

Ertapenem 1 g q24h

Cure

28.0
participants

Failure

1.0
participants

Indeterminate

Clinical Response to TP-434 and Ertapenem in the Clinically Modified Intent-to-treat (c-MITT) Population at the TOC Visit

TP-434, 1.5 mg/kg q24h

Cure

46.0
participants

Failure

3.0
participants

Indeterminate

5.0
participants

TP-434, 1.0 mg/kg q12h

Cure

47.0
participants

Failure

1.0
participants

Indeterminate

8.0
participants

Ertapenem 1 g q24h

Cure

26.0
participants

Failure

2.0
participants

Indeterminate

1.0
participants

Clinical Response to TP-434 and Ertapenem in the Clinically Modified Intent-to-treat (c-MITT) Population at the Follow-up Visit

TP-434, 1.5 mg/kg q24h

Cure

41.0
participants

Failure

4.0
participants

Indeterminate

9.0
participants

TP-434, 1.0 mg/kg q12h

Cure

45.0
participants

Failure

1.0
participants

Indeterminate

10.0
participants

Ertapenem 1 g q24h

Cure

24.0
participants

Failure

2.0
participants

Indeterminate

3.0
participants

Clinical Response to TP-434 and Ertapenem in the Microbiologically Modified Intent-to-treat (m-MITT) Population at the EOT Visit

TP-434, 1.5 mg/kg q24h

Cure

41.0
participants

Failure

2.0
participants

Indeterminate

2.0
participants

TP-434, 1.0 mg/kg q12h

Cure

44.0
participants

Failure

Indeterminate

3.0
participants

Ertapenem 1 g q24h

Cure

26.0
participants

Failure

1.0
participants

Indeterminate

Clinical Response to TP-434 and Ertapenem in the Microbiologically Modified Intent-to-treat (m-MITT) Population at the TOC Visit

TP-434, 1.5 mg/kg q24h

Cure

39.0
participants

Failure

3.0
participants

Indeterminate

3.0
participants

TP-434, 1.0 mg/kg q12h

Cure

41.0
participants

Failure

Indeterminate

6.0
participants

Ertapenem 1 g q24h

Cure

24.0
participants

Failure

2.0
participants

Indeterminate

1.0
participants

Clinical Response to TP-434 and Ertapenem in the Microbiologically Modified Intent-to-treat (m-MITT) Population at the Follow-up Visit

TP-434, 1.0 mg/kg q12h

Cure

39.0
participants

Failure

Indeterminate

8.0
participants

Ertapenem 1 g q24h

Cure

22.0
participants

Failure

2.0
participants

Indeterminate

3.0
participants

TP-434, 1.5 mg/kg q24h

Cure

36.0
participants

Failure

4.0
participants

Indeterminate

5.0
participants

Clinical Response to TP-434 and Ertapenem in the Clinically Evaluable (CE) Population at the EOT Visit

TP-434, 1.5 mg/kg q24h

Cure

47.0
participants

Failure

2.0
participants

Indeterminate

TP-434, 1.0 mg/kg q12h

Cure

47.0
participants

Failure

1.0
participants

Indeterminate

Ertapenem 1 g q24h

Cure

27.0
participants

Failure

1.0
participants

Indeterminate

Clinical Response to TP-434 and Ertapenem in the Clinically Evaluable (CE) Population at the TOC Visit

TP-434, 1.5 mg/kg q24h

Cure

46.0
participants

Failure

3.0
participants

Indeterminate

TP-434, 1.0 mg/kg q12h

Cure

47.0
participants

Failure

1.0
participants

Indeterminate

Ertapenem 1 g q24h

Cure

26.0
participants

Failure

2.0
participants

Indeterminate

Clinical Response to TP-434 and Ertapenem in the Clinically Evaluable (CE) Population at the Follow-up Visit

TP-434, 1.5 mg/kg q24h

Cure

41.0
participants

Failure

4.0
participants

Indeterminate

4.0
participants

TP-434, 1.0 mg/kg q12h

Cure

45.0
participants

Failure

1.0
participants

Indeterminate

2.0
participants

Ertapenem 1 g q24h

Cure

23.0
participants

Failure

2.0
participants

Indeterminate

3.0
participants

Clinical Response to TP-434 and Ertapenem in the Microbiologically Evaluable (ME) Population at the EOT Visit

TP-434, 1.5 mg/kg q24h

Cure

40.0
participants

Failure

2.0
participants

Indeterminate

TP-434, 1.0 mg/kg q12h

Cure

41.0
participants

Failure

Indeterminate

Ertapenem 1 g q24h

Cure

25.0
participants

Failure

1.0
participants

Indeterminate

Clinical Response to TP-434 and Ertapenem in the Microbiologically Evaluable (ME) Population at the Follow-up Visit

TP-434, 1.5 mg/kg q24h

Cure

36.0
participants

Failure

4.0
participants

Indeterminate

2.0
participants

TP-434, 1.0 mg/kg q12h

Cure

39.0
participants

Failure

Indeterminate

2.0
participants

Ertapenem 1 g q24h

Cure

21.0
participants

Failure

2.0
participants

Indeterminate

3.0
participants

Microbiologic Response to TP-434 and Ertapenem in the m-MITT Population at the EOT Visit

Microbiological response was classified as favorable (eradication or presumed eradication), unfavorable (persistence, presumed persistence, superinfection, or new infection), or indeterminate (assessment not possible).

TP-434, 1.5 mg/kg q24h

Favorable

41.0
participants

Indeterminate

2.0
participants

Unfavorable

2.0
participants

TP-434, 1.0 mg/kg q12h

Favorable

44.0
participants

Indeterminate

3.0
participants

Unfavorable

Ertapenem 1 g q24h

Favorable

26.0
participants

Indeterminate

Unfavorable

1.0
participants

Microbiologic Response to TP-434 and Ertapenem in the m-MITT Population at the TOC Visit

TP-434, 1.5 mg/kg q24h

Favorable

39.0
participants

Indeterminate

3.0
participants

Unfavorable

3.0
participants

TP-434, 1.0 mg/kg q12h

Favorable

42.0
participants

Indeterminate

5.0
participants

Unfavorable

Ertapenem 1 g q24h

Favorable

24.0
participants

Indeterminate

1.0
participants

Unfavorable

2.0
participants

Microbiologic Response to TP-434 and Ertapenem in the ME Population at the EOT Visit

TP-434, 1.5 mg/kg q24h

Favorable

40.0
participants

Indeterminate

Unfavorable

2.0
participants

TP-434, 1.0 mg/kg q12h

Favorable

41.0
participants

Indeterminate

Unfavorable

Ertapenem 1 g q24h

Favorable

25.0
participants

Indeterminate

Unfavorable

1.0
participants

Microbiologic Response to TP-434 and Ertapenem in the ME Population at the TOC Visit

TP-434, 1.5 mg/kg q24h

Favorable

39.0
participants

Indeterminate

Unfavorable

3.0
participants

TP-434, 1.0 mg/kg q12h

Favorable

41.0
participants

Indeterminate

Unfavorable

Ertapenem 1 g q24h

Favorable

24.0
participants

Indeterminate

Unfavorable

2.0
participants

Pharmacokinetics: Maximum Concentration (Cmax) of TP-434

TP-434, 1.5 mg/kg q24h

1445.625
nanograms per milliliter (ng/mL) (Mean)
Standard Deviation: 1168.029

TP-434, 1.0 mg/kg q12h

952.608
nanograms per milliliter (ng/mL) (Mean)
Standard Deviation: 759.754

Pharmacokinetics: Area Under the Concentration Time Curve From Time 0 to 12 Hours (AUC[0-12]) of TP-434

TP-434, 1.5 mg/kg q24h

4349.9
nanogram*hours per milliliter (ng*h/mL) (Mean)
Standard Deviation: 2186.791

TP-434, 1.0 mg/kg q12h

3240.724
nanogram*hours per milliliter (ng*h/mL) (Mean)
Standard Deviation: 1732.172

Total

143
Participants

Age, Continuous

42.6
years (Mean)
Standard Deviation: 17.64

Region of Enrollment

Sex: Female, Male

Overall Study

TP-434, 1.5 mg/kg q24h

TP-434, 1.0 mg/kg q12h

Ertapenem, 1 g q24h

Drop/Withdrawal Reasons

TP-434, 1.5 mg/kg q24h

TP-434, 1.0 mg/kg q12h

Ertapenem, 1 g q24h